Provider Demographics
NPI:1215138110
Name:YOON, STEVEN JIN (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:JIN
Last Name:YOON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:28049 SMYTH DR
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-4023
Mailing Address - Country:US
Mailing Address - Phone:661-705-9709
Mailing Address - Fax:661-702-1701
Practice Address - Street 1:15477 VENTURA BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-3006
Practice Address - Country:US
Practice Address - Phone:818-906-2141
Practice Address - Fax:818-906-6903
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA229610207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD227430YALFMedicare PIN
MD227425ZFXBMedicare PIN
MD227425ZFRZMedicare PIN